This invention relates to a method and apparatus for diagnosing esophagitis in a patient.
More particularly, the invention relates to portable apparatus of inexpensive manufacture which can quickly and easily be utilized in a hospital emergency room, in a physician's office, or at the residence of a patient to determine whether chest pains experienced by the patient are, instead of being caused by a heart condition, caused by esophagitis.
In another respect, the invention relates to esophagitis test apparatus which administers a test fluid to a patient under atmospheric pressure and the force of gravity and utilizes displacement pressures generated by peristaltic motion to assist in the distribution of the fluid in the esophagus of a patient.
As noted at page 54 in the February 1983 issue of the journal Hospital Practice:
"Next to abdominal pain, chest pain poses the most challenging differential diagnosis to the medical acumen of clinicians, who--rather than examine the patient at home, or even in the office, and face dependence on their clinical skills alone--now are prone to refer patients directly to the hospital emergency room. Once there, it is all too difficult to avoid the increasingly expensive technological "rule-out routine" in the face of medical, legal, and peer pressures for prompt decisions. A characteristic description of strangling retrosternal pain, accompanied by mortal anxiety and related to exertion, is new so habitually associated with coronary artery disease that angina due to other causes, such as pericarditis or esophagitis, are put on the far-back burner even in patients in low-risk coronary disease categories. As an interested student for many years of anterior chest pain of non-coronary disease origin, I was intrigued with a report from Ipswich, England, of 100 unselected consecutive emergency patients with anterior chest pain who were followed to their final diagnosis to discover, specifically, the prevalence of esophageal disease as a cause of their symptom. One fifth (16) of the 77 patients whose pain was definitely considered "anginal" had abnormalities of the esophagus demonstrated by endoscopy with biopsy, manometry, radiology, and acid perfusion (Bernstein and Baker method). None of these 16 had abnormal exercise tolerance tests. In eight a proactive test reproduced the symptoms. Esophageal acid perfusion was the most useful investigation in this group. However, in the remaining eight patients, testing reveal esophageal abnormalities that were not associated with pain at all. The authors conclude that the esophagus must be investigated in all patients with cardiac-like chest pain but apparently normal hearts, even when there is no overt sign of esophageal dysfunction, such as heartburn or dysphagia." PA1 "What is badly needed, therefore, is a simple, safe esophageal maneuver that turns on chest pain and has a high degree of sensitivity."
The editor in the above referenced February 1983 issue of Hospital Practice noted:
It would therefore be highly desirable to provide an improved method for testing for esophagitis patients who are experiencing chest pain.